Pelvic Organ Prolapse Management in Female Kidney Transplant Recipients

Abstract

Pelvic reconstructive surgery is feasible for pelvic organ prolapse in patients with a kidney allograft on immunosuppression. However, concern about impaired graft function, infection and wound healing remains important.

Surgical Management of Pelvic Organ Prolapse in a Woman with Right Pelvic Kidney

“…Up to date, there are no published data available regarding the safety/efficacy/choice of POP repair surgical procedures in women with a congenital pelvic kidney, although there are some published articles available in renal transplant patients [5][6][7]. It appears that POP surgery in renal transplanted women is technically possible with reportedly good outcomes.…”

“…For 3 to 36 months follow-up period, no complications were reported. Hoda et al (2010) presented 16 female renal transplant recipients with POP with or without SUI: a total of 12 anterior and 4 combined anterior/posterior colporrhaphies were performed [6]. A concomitant transobturator sling procedure was performed on 8 women.…”

“…At 12 months follow-up, only 25% (4 out of 16 women) exhibited stage 1 POP. Unlike the case series by Shveiky et al (2009) and Hoda et al (2010), which present vaginal repairs only in renal transplant patients, Rouffilange et al (2017) reports a laparoscopic double mesh SCP in a 73-year-old woman with a grafted kidney [7]. Despite immunosuppression due to anti-injection treatments, the postoperative course was uneventful.…”

“…Although there are some studies published on pelvic reconstruction surgery in renal transplant recipients, there is no article available on how to manage a woman with pelvic organ prolapse (POP) with a pelvic kidney [5][6][7]. Despite the rarity of pelvic kidney, it is imperative to be aware of this anatomical variation when managing a patient with pelvic kidney.…”

Laparoscopic Management of Pelvic Organ Prolapse in a Kidney Transplant Recipient

“…Two other studies evaluated POP treatment on renal transplant recipients. Hoda et al and Shveiky et al reported 21 transplanted patients who underwent pelvic reconstructive surgery for POP4, 5; a vaginal approach was used in all patients. No operative complications were recorded, and the follow-up showed excellent clinical outcomes.…”